Citicoline (INN) or CDP-choline (choline cytidine 5′-pyrophosphate) has recently attracted interest because it helps maintain acetylcholine levels at normal levels in the body. 

It is also known as cytidine diphosphate-choline or cytidine 5′-diphosphocholine and is an intermediate in the generation of phosphatidylcholine from choline which is an important  biochemical process in cell membrane production. The association with brain health is apparent simply from this type of reaction and in its role in supporting neurotransmission.

Acetylcholine is vital for normal neural function and is associated with regulating memory and cognitive functions. Citicoline is water-soluble and a precursor for phospholipid synthesis, especially phosphatidylcholine, found in brain tissue. Kyowa Hakko USA (Kyowa Hakko Europe GmbH) supply Cognizin™ (www.cognizin.com).

Regulatory Status

The EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) has published a scientific opinion on the safety of ‘citicoline’ as a Novel food ingredient (2013). The ingredient is deemed safe to use at the levels specified in the paper (EFSA, 2013). In 2014 (July 1st) it won EU novel foods approval for use in food supplements and medical foods after satisfying concerns regarding the phospholipid precursor being a medicine. Its maximum permitted use in food supplements is 500mg/day and 250mg/day in medical foods. The maximum recommended daily intake is 1g/day in the European Union.

Citicoline has been in use in the USA since the 1980s and was granted GRAS (Generally recognised as Safe) status in 2009 from the FDA. In that instance, the maximum permitted level was 250mg per serving in many food categories including drinks (beverages and fruit juices), cereals, chewing gum, hard and soft candies, and dairy products.

Clinical Studies On Citicoline

A study (McGlade et al., 2012) demonstrated that citicoline had cognition-enhancing benefits in a controlled study and two levels of  administration. Healthy female adult subjects were given citicoline and after 4 weeks, those taking 250mg demonstrated better performance in cognitive function tests compared to the control (no citicoline), whilst those taking a higher dose of 500mg not only had better scores than the lower level of addition, but also made much  better progress in the tests with very few mistakes recorded.

A study reported at the American Society of Clinical Psychopharmacology has found the feeding of citicoline to male teens increases their motor speed and attention. A randomised, double-blinded, placebo-controlled human clinical trial involved 75 adolescent males for 4 week period. Having been examined medically and clinical measures completed, the teens were randomly assigned to three treatment groups. This was 250 mg or 500 mg Cognizin™ or a placebo group.

To test the group, the “Finger Tap Test,” was applied which is a a motor function assessment during which participants press a lever attached to a mechanical counter as many times as possible during discrete time periods. Additionally, the “Ruff 2 & 7 Selective Attention Test” was also administered, which tests a timed cancellation task whereby participants cross out 2’s and 7’s embedded in blocks of distractor numbers or letters. The individuals administered citicoline scored higher in both tests after the 28-day period.

References

EFSA (2013) Scientific Opinion on the safety of ‘citicoline’ as a Novel Food ingredient. EFSA Journal 11(10):3421. 22 pages

McGlade, E., Locatelli, A., Hardy, J., Kamiya, T., Morita, M., Morishita, K., Sugimura, Y., Yurgelun-Todd, D. (2012) Improved attentional performance following citicoline administration in healthy adult women. Food and Nutrition Sciences, 3, pp. 769-773.

Revision 1st August 2017 .